Something seemingly as innocuous as a crouton flake in a bowl of soup can affect Diane Craig's health.

The 60-year-old Carmichael resident encountered just such a hazard when she and fellow members of her celiac disease support group dined at a local chain restaurant.

They had chosen the lunch spot specifically because it boasted a gluten-free menu, essential for people such as Craig who suffer from the autoimmune condition that causes the intestines to lose the ability to absorb nutrients. Gluten, a type of protein, is found in wheat, barley and rye.

But the roasted potato-garlic soup that a dining companion ordered seemed safe, so when her friend offered, Craig took a little sip.

"I got home and immediately knew it wasn't gluten-free," Craig says. "My friend barely made it out of the parking lot."

After the two got over their intestinal distress, they contacted the restaurant. The manager told them he thought a crouton may have inadvertently fallen into in the soup. Result: That restaurant's gluten-free menu now reads: "Roasted Garlic Soup (hold croutons)."

"It's all about communication," says Craig, chairwoman of the Sacramento Celiac Sprue Association. "People, by now, have heard about celiac but there's still misconceptions. No, we can't have a little bit of wheat. And, yes, it matters what's in our medications, because you'll find it there, too."

It takes a lot of dietetic diligence to live well with celiac disease, Craig adds, but it can be done. The National Institutes for Health estimates that 3 million Americans are affected. And the research firm Mintel reports that $1.75 billion was spent on gluten-free foods in 2007.

"The great news is, when you take away the gluten, the ill effects of the disease goes away," Craig says. "It's the one autoimmune condition in which you can do that. Get well, stay well. I ran my first half- marathon in May."

So as long as Craig does not ingest gluten in any form, normal life is not affected. However, gluten often is hidden in foods and medicines as an emulsifier.

"For instance, soy sauce is made with wheat," Craig says. "People don't realize beer has gluten in it. But there are gluten-free alternatives for everything, including beer now. That's relatively new."

Craig herself does not imbibe. But she has long used gluten-free products to make meals for her two now-grown children, Aidan and Nathaniel, who both have the condition.

Back in the 1980s, when she and her boys were first diagnosed, food options weren't so plentiful. Nor were restaurants savvy enough to handle the special requests.

Doctors, too, weren't as familiar with celiac disease.

In fact, when Craig found herself getting sick in 1985 – losing weight and muscle strength and feeling bone pain – her doctor ruled out physical causes and told her she had depression. The diagnosis was reached despite the fact her two sons both were celiac sufferers. She recalls going to the Carmichael public library to research depression and finding a book listing the adult symptoms of the disease.

"My 'a-ha' moment came when I read that diarrhea doesn't have to be (a symptom) for adults, and that was my case," she says. "Once I knew what I had, and took care of it, I've felt great since."

And she expects to remain healthy – if she can avoid croutons.

Call The Bee's Sam McManis, (916) 321-1145.